Osteochondrosis of the cervical spine or cervical osteochondrosis is a disease of degenerative-dystrophic genesis that affects the intervertebral discs and cervical vertebrae with the formation of intervertebral protuberances and hernias, which ultimately leads to dysfunction of the spinal cord and isoften the cause of disability.
Features of the structure of the cervical spine
The vertebrae are the bones from which the spine is built. Each vertebra has a body that carries all the load, the vertebral arch, the transverse and spinous processes.
The vertebral arches of the vertebrae form the vertebral canal through which the spinal cord passes. The processes of the spine are designed to anchor the muscles of the back.
There are also anterior and posterior ligaments that connect the vertebrae to each other.
The intervertebral disc is a rounded flat structure that consists of a fibrous ring and a nucleus pulposus, the main function of which is shock absorption. The intervertebral discs are located between the vertebrae.
The facet joint is a movable connection of the processes of two adjacent vertebrae. The facet joints provide flexibility to the spine.
Intervertebral foramina are foramina formed by structural elements (legs, articular processes) of two adjacent vertebrae and intended for the exit of the radicular nerves of the spinal cord.
There are paravertebral muscles to support the spine and its various movements.
The cervical spine is the tallest and most mobile part of the spine, which consists of seven vertebrae and is C-shaped due to its forward curvature (cervical lordosis).
All movements of the head - tilting, rotating, circular, are provided by this part of the spine.
Interesting!In addition, the cervical spine is the most traumatized part, since the cervical vertebrae have low resistance and a weak muscular apparatus, compared to others.
For the same reason, osteochondrosis of the cervical spine often occurs.
Prevalence of cervical osteochondrosis
Osteochondrosis of the cervical spine affects the working-age population over the age of 30. This disease is more common in women than in men.
According to the World Health Organization, 40 to 90% of the world's population suffers from osteochondrosis.
Important!One in two patients with osteochondrosis have dystrophic and degenerative changes in the cervical spine.
Causes of osteochondrosis of the cervical spine
Osteochondrosis can be called a tribute to a person's ability to stand and walk on two legs. This opinion is confirmed by the fact that no animal that walks on all fours suffers from osteochondrosis.
Despite the availability of modern methods of diagnosing diseases and extensive knowledge of human anatomy and physiology, it has not yet been possible to establish the specific causes of osteochondrosis.
But reliable factors are known which lead to degenerative-dystrophic changes in the spine. These include the following:
- insufficiently mobile lifestyle of a person, which leads to a weakening of the muscular apparatus of the back. Often office workers, cashiers, salespeople and drivers suffer from osteochondrosis;
- hard physical work;
- mechanical back injury;
- genetic predisposition to osteochondrosis;
- overweight and obesity;
- neuropsychic stress;
- inappropriate workouts in the gym;
- beriberi, micronutrient deficiency, metabolic disorders;
- bad nutrition;
- the presence of diseases of the kidneys, digestive and endocrine systems;
- Infectious diseases;
- frequent hypothermia of the body;
- congenital and acquired immunodeficiencies.
Pathogenesis (mechanism of development) of cervical osteochondrosis
Almost all of the factors contributing to the development of osteochondrosis lead to spasm of the back muscles. In turn, muscle spasms disrupt the blood supply and metabolism of bone tissue of the vertebrae and intervertebral discs.
Thus, dystrophic changes occur, that is, drying out, dehydration and loss of elasticity of the vertebrae and intervertebral discs.
Additional stress on the spine leads to flattening, protrusion (protrusion beyond the fibrous ring) of the intervertebral discs.
No less important in the pathogenesis of cervical osteochondrosis is the burden of maintaining and moving the head.
The load on the cervical vertebrae is huge, since the average weight of the head is 3-5 kg, and their bone tissue, unfortunately, is fragile and thin.
In addition, the development of osteochondrosis is facilitated by technical advances - smartphones, tablets, e-books, if you bend over using these gadgets.
The intervertebral discs cannot effectively cushion the spine, therefore compensatory mechanisms are triggered.
Important!One of these mechanisms is the proliferation of osteophytes and the development of spondylosis.
False joints can also form along the back surface of the vertebrae of the cervical spine - uncovertebral osteoarthritis.
All these processes ultimately lead to a decrease in cervical lordosis (hypolordosis), protuberances and intervertebral discs, which sooner or later become the main cause of disability in a person or require urgent surgical treatment.
The pathogenesis of cervical osteochondrosis can be divided into four stages:
- The appearance of instability of cervical vertebrae;
- The formation of protrusion of the intervertebral discs, a decrease in the intervertebral fissure, the onset of destruction of the fibrous ring, which leads to pinching of the nerves, which is manifested by pain in the neck;
- The annulus fibrosus is completely destroyed and the nucleus pulposus extends beyond its borders, thus, an intervertebral hernia is formed and the spine is deformed;
- Stage of disability. The vertebrae grow together. It is difficult for patients to move around. Sometimes the condition can improve, but not for long.
Symptoms and syndromes of osteochondrosis of the cervical spine
The main symptoms of cervical osteochondrosis are as follows:
- persistent neck pain of a throbbing or aching nature, which may spread to the occipital region of the head, eye sockets, ears and shoulder girdle;
- pain in the upper limbs, which increases when moving;
- stiffness of movements of the upper limbs, violation of their sensitivity (tingling, burning, numbness), weakening of the strength of the muscles;
- morning stiffness in the neck;
- pain in the cervical spine when moving the head;
- periodic dizziness with cervical osteochondrosis, darkening of the eyes, loss of consciousness with sudden turns of the head;
- feeling of tinnitus;
- hearing and visual impairment;
- feeling of numbness and tingling in the tongue;
- cardialgia (pain in the heart), sometimes cervical osteochondrosis is confused with acute coronary syndrome. The difference is the lack of effect of nitrates;
- Due to microcirculation disorders and oxygen deficiency in the tissues, connective tissue proliferates in the cervical spine, which is called the "tourniquet".
All symptoms of cervical osteochondrosis can be grouped into the following syndromes:
- reflex;
- root;
- root-vascular;
- spinal compression;
- cerebral.
Reflex syndrome consists of neck pain - severe pain in the neck, due to which the patient is forced to fix the head and strain the muscles of the neck.
The sensation of spinous processes, paravertebral points and intervertebral discs brings and / or increases pain.
In addition, the reflex syndrome is characterized by pain in the upper extremities, occipital or temporal regions of the head.
Radicular syndrome is a combination of sharp acute pain that increases with movement of the head and results from pinching of the nerves in the intervertebral foramen.
Radicular-vascular syndrome is characterized by vegetative-trophic disorders in the form of humero-scapular periarthritis.
The patient is worried about pain in the shoulder joint, stiffness of movements, altered sensitivity of the skin, swelling of the hand and the wrist joint. In addition, the patient cannot bring his hands back.
Spinal compression syndrome occurs due to compression of the spinal cord and its vascular system. Herniated discs, osteophytes, thickening of the yellow ligament can lead to it.
Interesting!Patients present with pain in the neck and shoulder region, flaccid paresis of the upper limbs and spastic paresis of the lower limbs, altered sensitivity.
Brain syndrome with cervical osteochondrosis combines several of these syndromes:
- Diencephalic syndrome - increased irritability, neurasthenia, general weakness, insomnia, distraction. In severe cases, there is anxiety, numbness of the upper and lower extremities, increased sweating, chills;
- Posterior cervical sympathetic bar syndrome or "cervical migraine" - severe headache, such as migraine in one half of the head against the background of dizziness, visual and hearing impairment, feeling of numbness in the hands.
- syncope syndrome - fainting with a sudden turn of the head;
- syndromes of the vestibular trunk and cochlear trunk - dizziness, instability when walking, nausea and even vomiting;
- visual disturbance syndrome - deterioration of vision, visual disturbances, blinking of "dots", "flies" in front of the eyes.
Diagnosis of osteochondrosis of the cervical spine
Like any diagnosis in medicine, the diagnosis of osteochondrosis of the cervical spine is made on the basis of the patient's complaints, medical history, examination and auxiliary research methods.
In addition to the clinical examination, the patient should undergo the following methods:
- X-ray of the cervical spine;
- CT scan of the cervical spine;
- Magnetic resonance imaging of the cervical spine;
- Doppler ultrasound examination of the vessels of the neck;
After diagnostic measures, the doctor chooses treatment tactics based on the results of diagnostics and analyzes.
Treatment of osteochondrosis of the cervical spine
Treatment of osteochondrosis of the cervical spine consists of eliminating the radicular syndrome and eliminating the inflammatory process.
In the acute period of the disease, you need to adhere to strict bed rest. The soft mattress should be replaced with a hard mattress or a wooden shield should be placed on it.
Drug treatment of cervical osteochondrosis is carried out with the help of the following groups of drugs:
- nonsteroidal anti-inflammatory drugs;
- drugs of the chondroprotective group;
- pain relievers and anti-inflammatory gels and ointments;
- vitamin preparations - ascorbic acid, retinol acetate, tocopherol acetate;
- calcium preparations;
- drugs that improve microcirculation in tissues;
- muscle relaxants.
Treatment of cervical osteochondrosis includes the following methods:
- wearing a special collar around the neck, which not only relieves the burden on the neck, but also restricts movement;
- stretching with a slip loop - the patient's head, who is lying on the bed, is fixed with a slip loop, and the head of the bed is raised 20-30 cm. This procedure relaxes the muscle corset of the spine, increases the intervertebral fissures, releases the pinched nerves;
- Manual therapy for cervical osteochondrosis should be performed only by an experienced manual therapist. Manual therapy is performed using relaxing and segmental massage techniques, mobilization, which restores damaged joint functions, and manipulations to restore full range of motion in the joints.
- physiotherapy methods for osteochondrosis of the cervical spine - diadynamic therapy, electrotherapy, laser therapy, shock wave therapy, balneotherapy, treatment with ultrasound and ultraviolet rays, magnetotherapy and other methods.
- Physiotherapy for cervical osteochondrosis includes exercises to strengthen the muscle corset. Exercise is suitable not only for the treatment of osteochondrosis, but also for prevention. They can be done before going to bed at home, at the gym, at work, and at school during breaks.
Surgical treatment of cervical osteochondrosis
Treatment with surgical methods is indicated for severe radicular syndrome, which cannot be relieved by drugs, with increased motor and sensory functions of the upper extremities, as well as compression of the spinal cord.
Important!Ablation operations for intervertebral herniated discs and osteophytes are widely used.
Prevention of osteochondrosis of the cervical spine
- healthy sleep on an orthopedic mattress;
- use a low pillow;
- regularly visit the sauna or the bath. The steam perfectly relaxes the muscles of the neck;
- you need to take a hot shower every day for at least 10 minutes;
- playing sports, gymnastics, walking. Swimming, yoga, Pilates are great for this;
- all head movements should be precise, without sharp turns;
- correctly distribute the load on the spine during physical work and sports;
- take breaks and warm-ups during sedentary work;
- maintain the correct posture when sitting at a table or at a computer;
- chairs and a table should be suitable for your height.